ISSN: 1859 - 2872
Effects of Vitamin D supplementation on inflammatory markers in patients with severe burns
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Abstract
Objective: To evaluate the effects of vitamin D supplementation on inflammatory indices in patients with severe burns. Subject and method: This controlled clinical trial included 104 patients with severe burns treated in the Intensive Care Unit of Le Huu Trac National Burn Hospital from March 2023 to September 2025. Group 1 (control) comprised 63 patients who received the hospital’s standard treatment protocol, whereas Group 2 (intervention) comprised 41 patients who received the same standard treatment plus vitamin D3 supplementation at a total dose of 500,000 IU administered over five consecutive days. The neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation response index (SIRI) were assessed at admission (T0), day 7 (T7), day 14 (T14), and day 28 (T28). Changes in inflammatory indices over time were analyzed using a linear mixed model (LMM) for ln(NLR) and generalized estimating equations (GEE) for SIRI. Result: NLR values were comparable between the two groups at T0 and T7, but a statistically significant difference emerged from T14, with NLR being 20.8% lower in the vitamin D supplementation group than in the control group (p=0.041), and 31.1% lower at T28 (p=0.007). NLR decreased by an average of 3.16% per day in the intervention group compared with 1.47% per day in the control group; the group-by-day interaction was statistically significant (p=0.004). SIRI values were comparable between the two groups at T0 and T7, with significant divergence emerging at T14 and T28. The intervention-to-control SIRI ratio decreased to 0.720 at T14 and 0.640 at T28, with significant group-by-time interaction terms at T14 (p=0.004) and T28 (p=0.013), respectively. SIRI decreased by approximately 3.7% per day in the vitamin D supplementation group compared with 0.8% per day in the control group; the group-by-day interaction was statistically significant (p<0.001). Conclusion: Vitamin D3 supplementation at a total dose of 500,000 IU over five consecutive days in patients with severe burns and vitamin D deficiency was associated with greater reductions in NLR and SIRI than standard treatment alone, particularly from days 14 to 28.
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References
2. Zavala S, Larson J, O'Mahony M, Rech MA (2020) Impact of insufficient admission vitamin D serum concentrations on sepsis incidence and clinical outcomes in patients with thermal injury. Burns: journal of the International Society for Burn Injuries 46(1): 172-177. doi:10.1016/j.burns.2019.02.025
3. Gottschlich MM, Mayes T, Khoury J, Kagan RJ (2017) Clinical trial of vitamin D(2) vs D(3) supplementation in critically Ill pediatric burn patients. JPEN Journal of parenteral and enteral nutrition 41(3): 412-421. doi:10.1177/0148607115587948
4. Ghadimi E, Rahbar R, Jafarzade E, Mansoori A (2025) Effects of vitamin D3 supplementation on the recovery of hospitalized burn patients: A randomized double-blind controlled trial. BMC Nutr 11(1): 37. doi:10.1186/s40795-025-01024-2
5. Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2011) Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism 96(7): 1911-1930. doi:10.1210/jc.2011-0385
6. Smith EM, Jones JL, Han JE et al (2018) High-Dose Vitamin D(3) Administration Is Associated With Increases in Hemoglobin Concentrations in Mechanically Ventilated Critically Ill Adults: A Pilot Double-Blind, Randomized, Placebo-Controlled Trial. JPEN Journal of parenteral and enteral nutrition. 42(1): 87-94. doi:10.1177/0148607116678197
7. Ghadimi E, Rahbar R, Jafarzade E, Mansoori A (2025) Effects of vitamin D3 supplementation on the recovery of hospitalized burn patients: A randomized double-blind controlled trial. BMC Nutrition 11(1):37. doi:10.1186/s40795-025-01024-2
8. Hung TD, Lam NN, Hung NT (2024) Prognostic values of neutrophil/lymphocyte ratio in severe burn patients. Annals of burns and fire disasters 37(2): 124-129.
9. Dziedzic EA, Gąsior JS (2022) The Association between Serum Vitamin D Concentration and New Inflammatory Biomarkers-Systemic Inflammatory Index (SII) and Systemic Inflammatory Response (SIRI)-In Patients with Ischemic Heart Disease. 14(19). doi:10.3390/nu14194212
10. Tabatabaeizadeh SA, Avan A (2017) High Dose Supplementation of Vitamin D Affects Measures of Systemic Inflammation: Reductions in High Sensitivity C-Reactive Protein Level and Neutrophil to Lymphocyte Ratio (NLR) Distribution. 118(12): 4317-4322. doi:10.1002/jcb.26084
11. Maghbooli Z, Sahraian MA, Jamalimoghadamsiahkali S et al (2021) Treatment With 25-Hydroxyvitamin D(3) (Calcifediol) Is Associated With a Reduction in the Blood Neutrophil-to-Lymphocyte Ratio Marker of Disease Severity in Hospitalized Patients With COVID-19: A Pilot Multicenter, Randomized, Placebo-Controlled, Double-Blinded Clinical Trial. Endocrine practice: Official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 27(12): 1242-1251. doi:10.1016/j.eprac.2021.09.016
12. Zhao H, Zhao Y, Fang Y, Zhou W, Zhang W, Peng J (2025) The Relationship Between Novel Inflammatory Markers and Serum 25-Hydroxyvitamin D Among US Adults. Immunity, inflammation and disease 13(1): 70115. doi:10.1002/iid3.70115.